Cardiovascular

System

The Blood Vessels

The cardiovascular system has
three types of blood vessels:
Arteries (and arterioles) carry
blood away from the heart
Capillaries where nutrient and gas
exchange occur
Veins (and venules) carry blood
toward the heart.

Blood vessels

The Arteries
Arteries and arterioles take blood
away from the heart.
The largest artery is the aorta.
The middle layer of an artery wall
consists of smooth muscle that can
constrict to regulate blood flow and
blood pressure.
Arterioles can constrict or dilate,
changing blood pressure.

The Capillaries

Capillaries have walls only one cell

thick to allow exchange of gases and
nutrients with tissue fluid.
Capillary beds are present in all
regions of the body but not all capillary
beds are open at the same time.
Contraction of a sphincter muscle
closes off a bed and blood can flow
through an arteriovenous shunt that
bypasses the capillary bed.

Anatomy of a capillary
bed

The Veins
Venules drain blood from capillaries,
then join to form veins that take
blood to the heart.
Veins have much less smooth
muscle and connective tissue than
arteries.
Veins often have valves that prevent
the backward flow of blood when
closed.
Veins carry about 70% of the bodys
blood and act as a reservoir during
hemorrhage.

The Heart
The heart is a cone-shaped, muscular
organ located between the lungs
behind the sternum.
The heart muscle forms the
myocardium, with tightly interconnect
cells of cardiac muscle tissue.
The pericardium is the outer
membranous sac with lubricating
fluid.

The heart has four chambers: two upper,

thin-walled atria, and two lower, thickwalled ventricles.
The septum is a wall dividing the right
and left sides.
Atrioventricular valves occur between
the atria and ventricles the tricuspid
valve on the right and the bicuspid valve
on the left; both valves are reenforced by
chordae tendinae attached to muscular
projections within the ventricles.

External heart
anatomy

Coronary artery
circulation

Passage of Blood
Through the Heart

Blood follows this sequence through

the heart: superior and inferior vena
cava right atrium tricuspid valve
right ventricle pulmonary
semilunar valve pulmonary trunk
and arteries to the lungs pulmonary
veins leaving the lungs left atrium
bicuspid valve left ventricle aortic
semilunar valve aorta to the
body.

Internal view of the

heart

The pumping of the heart sends out

blood under pressure to the arteries.
Blood pressure is greatest in the
aorta; the wall of the left ventricle is
thicker than that of the right ventricle
and pumps blood to the entire body.
Blood pressure then decreases as the
cross-sectional area of arteries and
then arterioles increases.

Path of blood through the

heart

The Heartbeat

Each heartbeat is called a cardiac cycle.

When the heart beats, the two atria
contract together, then the two
ventricles contract; then the whole
heart relaxes.
Systole is the contraction of heart
chambers; diastole is their relaxation.
The heart sounds, lub-dup, are due to
the closing of the atrioventricular
valves, followed by the closing of the
semilunar valves.

Intrinsic Control of
Heartbeat
The SA (sinoatrial) node, or pacemaker,
initiates the heartbeat and causes the
atria to contract on average every 0.85
seconds.
The AV (atrioventricular) node conveys
the stimulus and initiates contraction of
the ventricles.
The signal for the ventricles to contract
travels from the AV node through the
atrioventricular bundle to the smaller
Purkinje fibers.

Conduction system of
the heart

Extrinsic Control of
Heartbeat
A cardiac control center in the medulla
oblongata speeds up or slows down
the heart rate by way of the
autonomic nervous system branches:
parasympathetic system (slows heart
rate) and the sympathetic system
(increases heart rate).
Hormones epinephrine and
norepinephrine from the adrenal
medulla also stimulate faster heart
rate.

The Electrocardiogram
An electrocardiogram (ECG) is a
recording of the electrical changes
that occur in the myocardium during
a cardiac cycle.
Atrial depolarization creates the P
wave, ventricle depolarization
creates the QRS wave, and
repolarization of the ventricles
produces the T wave.

Electrocardiogram

The Vascular Pathways

1)

2)

3)

The cardiovascular system

includes two circuits:
Pulmonary circuit which circulates
blood through the lungs, and
Systemic circuit which circulates
blood to the rest of the body.
Both circuits are vital to
homeostasis.

Cardiovascular system
diagram

The Pulmonary Circuit

The pulmonary circuit begins with

the pulmonary trunk from the right
ventricle which branches into two
pulmonary arteries that take
oxygen-poor blood to the lungs.
In the lungs, oxygen diffuses into the
blood, and carbon dioxide diffuses
out of the blood to be expelled by
the lungs.
Four pulmonary veins return oxygenrich blood to the left atrium.

The Systemic Circuit

The systemic circuit starts with the
aorta carrying O2-rich blood from
the left ventricle.
The aorta branches with an artery
going to each specific organ.
Generally, an artery divides into
arterioles and capillaries which
then lead to venules.

The vein that takes blood to the vena

cava often has the same name as the
artery that delivered blood to the
organ.
In the adult systemic circuit, arteries
carry blood that is relatively high in
oxygen and relatively low in carbon
dioxide, and veins carry blood that is
relatively low in oxygen and relatively
high in carbon dioxide.
This is the reverse of the pulmonary
circuit.

Major arteries and veins

of the systemic circuit

The coronary arteries serve the

heart muscle itself; they are the
first branch off the aorta.
Since the coronary arteries are
so small, they are easily clogged,
leading to heart disease.
The hepatic portal system carries
blood rich in nutrients from
digestion in the small intestine to
the liver, the organ that monitors
the composition of the blood.

Blood Flow
The beating of the heart is
necessary to homeostasis
because it creates pressure that
propels blood in arteries and the
arterioles.
Arterioles lead to the capillaries
where nutrient and gas exchange
with tissue fluid takes place.

Blood Flow in Arteries

Blood pressure due to the pumping

of the heart accounts for the flow of
blood in the arteries.
Systolic pressure is high when the
heart expels the blood.
Diastolic pressure occurs when the
heart ventricles are relaxing.
Both pressures decrease with
distance from the left ventricle
because blood enters more and
more arterioles and arteries.

Cross-sectional area as it
relates to blood pressure and
velocity

Blood Flow in
Capillaries
Blood moves slowly in capillaries
because there are more
capillaries than arterioles.
This allows time for substances to
be exchanged between the blood
and tissues.

Blood Flow in Veins

1)
2)
3)

Venous blood flow is dependent upon:

skeletal muscle contraction,
presence of valves in veins, and
respiratory movements.
Compression of veins causes blood to
move forward past a valve that then
prevents it from returning backward.

Changes in thoracic and abdominal

pressure that occur with breathing
also assist in the return of blood.
Varicose veins develop when the
valves of veins become weak.
Hemorrhoids (piles) are due to
varicose veins in the rectum.
Phlebitis is inflammation of a vein
and can lead to a blood clot and
possible death if the clot is dislodged
and is carried to a pulmonary vessel.

Blood

Blood separates into two main parts:

plasma and formed elements.
Plasma accounts for 55% and formed
elements 45% of blood volume.
Plasma contains mostly water (9092%)
and plasma proteins (78%), but it also
contains nutrients and wastes.
Albumin is a large plasma protein that
transports bilirubin; globulins are plasma
proteins that transport lipoproteins.

Composition of blood

The Red Blood Cells

Red blood cells (erythrocytes or RBCs)

are made in the red bone marrow of
the skull, ribs, vertebrae, and the
ends of long bones.
Normally there are 4 to 6 million RBCs
per mm3 of whole blood.
Red blood cells contain the pigment
hemoglobin for oxygen transport;
hemogobin contains heme, a complex
iron-containing group that transports
oxygen in the blood.

Physiology of red blood

cells

The air pollutant carbon

monoxide combines more readily
with hemoglobin than does
oxygen, resulting in oxygen
deprivation and possible death.
Red blood cells lack a nucleus
and have a 120 day life span.
When worn out, the red blood
cells are dismantled in the liver
and spleen.

Iron is reused by the red bone marrow

where stem cells continually produce
more red blood cells; the remainder
of the heme portion undergoes
chemical degradation and is excreted
as bile pigments into the bile.
Lack of enough hemoglobin results in
anemia.
The kidneys produce the hormone
erythropoietin to increase blood cell
production when oxygen levels are
low.

The White Blood Cells

White blood cells (leukocytes) have

nuclei, are fewer in number than
RBCs, with 5,000 10,000 cells per
mm3, and defend against disease.
Leukocytes are divided into granular
and agranular based on appearance.
Granular leukocytes (neutrophils,
eosinophils, and basophils) contain
enzymes and proteins that defend
the body against microbes.

The aganular leukocytes (monocytes

and lymphocytes) have a spherical or
kidney-shaped nucleus.
Monocytes can differentiate into
macrophages that phagocytize
microbes and stimulate other cells to
defend the body.
Lymphocytes are involved in immunity.
An excessive number of white blood
cells may indicate an infection or
leukemia; HIV infection drastically
reduces the number of lymphocytes.

Macrophage engulfing
bacteria

The Platelets and Blood

Clotting

Red bone marrow produces large

cells called megakaryocytes that
fragment into platelets at a rate of
200 billion per day; blood contains
150,000300,000 platelets per mm3.
Twelve clotting factors in the blood
help platelets form blood clots.

Blood Clotting

Injured tissues release a clotting factor

called prothrombin activator, which
converts prothrombin into thrombin.
Thrombin, in turn, acts as an enzyme
and converts fibrinogen into insoluble
threads of fibrin.
These conversions require the
presence of calcium ions (Ca2+).
Trapped red blood cells make a clot
appear red.

Blood clotting

Hemophilia

Hemophilia is an inherited clotting

disorder due to a deficiency in a
clotting factor.
Bumps and falls cause bleeding in the
joints; cartilage degeneration and
resorption of bone can follow.
The most frequent cause of death is
bleeding into the brain with
accompanying neurological damage.

Bone Marrow Stem

Cells
A stem cell is capable of dividing
into new cells that differentiate into
particular cell types.
Bone marrow is multipotent, able to
continually give rise to particular
types of blood cells.
The skin and brain also have stem
cells, and mesenchymal stem cells
give rise to connective tissues
including heart muscle.

Blood cell formation in red

bone marrow

Capillary Exchange

At the arteriole end of a capillary,

water moves out of the blood due to
the force of blood pressure.
At the venule end, water moves into
the blood due to osmotic pressure of
the blood.
Substances that leave the blood
contribute to tissue fluid, the fluid
between the bodys cells.

In the midsection of the capillary,

nutrients diffuse out and wastes
diffuse into the blood.
Since plasma proteins are too large
to readily pass out of the capillary,
tissue fluid tends to contain all
components of plasma except it has
lesser amounts of protein.
Excess tissue fluid is returned to the
blood stream as lymph in lymphatic
vessels.

Capillary exchange

Cardiovascular Disorders

Cardiovascular disease (CVD) is the

leading cause of death in Western
countries.
Modern research efforts have improved
diagnosis, treatment, and prevention.
Major cardiovascular disorders include
atherosclerosis, stroke, heart attack,
aneurysm, and hypertension.

Atherosclerosis
Atherosclerosis is due to a build-up of
fatty material (plaque), mainly
cholesterol, under the inner lining of
arteries.
The plaque can cause a thrombus
(blood clot) to form.
The thrombus can dislodge as an
embolus and lead to
thromboembolism.

Stroke, Heart Attack,

and Aneurysm

A cerebrovascular accident, or stroke,

results when an embolus lodges in a
cerebral blood vessel or a cerebral
blood vessel bursts; a portion of the
brain dies due to lack of oxygen.
A myocardial infarction, or heart
attack, occurs when a portion of heart
muscle dies due to lack of oxygen.

Partial blockage of a coronary artery

causes angina pectoris, or chest pain.
An aneurysm is a ballooning of a
blood vessel, usually in the abdominal
aorta or arteries leading to the brain.
Death results if the aneurysm is in a
large vessel and the vessel bursts.
Atherosclerosis and hypertension
weaken blood vessels over time,
increasing the risk of aneurysm.

Coronary Bypass
Operations

A coronary bypass operation

involves removing a segment of
another blood vessel and replacing
a clogged coronary artery.
It may be possible to replace this
surgery with gene therapy that
stimulates new blood vessels to
grow where the heart needs more
blood flow.

Coronary bypass
operation

Clearing Clogged
Arteries

Angioplasty uses a long tube

threaded through an arm or leg
vessel to the point where the
coronary artery is blocked; inflating
the tube forces the vessel open.
Small metal stents are expanded
inside the artery to keep it open.
Stents are coated with heparin to
prevent blood clotting and with
chemicals to prevent arterial closing.

Angioplasty

Dissolving Blood Clots

Medical treatments for dissolving

blood clots include use of t-PA (tissue
plasminogen activator) that converts
plasminogen into plasmin, an
enzyme that dissolves blood clots,
but can cause brain bleeding.
Aspirin reduces the stickiness of
platelets and reduces clot formation
and lowers the risk of heart attack.

Heart Transplants and

Artificial Hearts
Heart transplants are routinely
performed but immunosuppressive
drugs must be taken thereafter.
There is a shortage of human organ
donors.
Work is currently underway to
improve self-contained artificial
hearts, and muscle cell transplants
may someday be useful.

Hypertension

About 20% of Americans suffer from

hypertension (high blood pressure).
Hypertension is present when systolic
pressure is 140 or greater or diastolic
pressure is 100 or greater; diastolic
pressure is emphasized when medical
treatment is considered.
A genetic predisposition for
hypertension occurs in those who have
a gene that codes for angiotensinogen,
a powerful vasoconstrictor.

end